Malignant oesophageal stricture

There is a long irregular stricture affecting the mid- and lower oesophagus. The pattern of obstruction is in keeping with an extrinsic infiltrating mass. On careful inspection, it is clear that the density of the left lung is

B increased. The left lung has collapsed due to a mass at the hilum/mediastinum. The diagnosis is carcinoma of the left lower lobe bronchus with an associated mediastinal mass. There is extrinsic compression and invasion of the oesophagus where the mass is invading the mediastinum. The patient is not ventilating the left lung.

Surgery would be a major undertaking. The patient requires careful pre-operative assessment with careful consideration of his cardiovascular and respiratory state, and his ability to survive the procedure, before surgery is booked.

If surgery is undertaken, one-lung ventilation after placement of a double lumen tube, would facilitate surgical access. Invasive monitoring and post-operative ITU care would be required.

Age 34.

Recurrent episodes of right lower quadrant abdominal pain.

(Fig. 2.24)? ■ What is the examination? ■ What are the

Fig. 2.24 Quiz case.

Age 34.

Recurrent episodes of right lower quadrant abdominal pain.

(Fig. 2.24)? ■ What is the examination? ■ What are the diagnosis?

radiological features

Fig. 2.24 Quiz case.

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